Face blindness segment on 60 Minutes

CBS’s 60 Minutes ran a segment about face blindness last night, and I figured I’d share some thoughts about it.

If I could add captions to the movie, that would be fun, but I don’t know how to do that.  So I’ll try writing a running commentary according to the time index of the video.

Part 1:

0:10  It’s been a while since I watched this program.  Goodness, they are being dramatic, with correspondent Lesley Stahl giving her introduction from an endless black void with a creepy picture hovering behind her!

0:45  As you might expect, the report mostly focuses on some of the most extreme examples of face blindness, because… well, that’s more dramatic!  My own face blindness is not as severe as most of the examples they will talk about in this segment.  (Also, while face blindness is often a trait of autism/Asperger’s, many faceblind people are not autistic.)

I have never had trouble recognizing my close family members or myself in a mirror.  And I was able to recognize my high school classmates right away at our reunion. But I’ve spent years with those people where I saw them on a daily basis and spent time getting to know them.  I start to have trouble with people I only see from time to time.

1:20  This is something I’ve always wondered about 60 Minutes.  Do they make sure that the stopwatch is always at the right minute and second based on when the commercial breaks come, or do they fudge things a bit?  It looks like the watch is running about 20 seconds fast here, but I think that’s because they cut the “Tonight on 60 minutes…” part out of the video.  What?  Oh, face blindness. Sorry.

2:00  I have at least some facial recognition ability, because I can recognize most of these celebrities.  And the ones I have trouble with are possibly due to unfamiliarity with the celebrity rather than face blindness.  But this is easier than real life facial recognition, because 1) I already know it’s a celebrity, and 2) the faces don’t move or start to wonder why I’m staring at them.

2:22  This camera shot is a more accurate representation of the task in real life.  All those faces going by– how can I pick out the ones I’ve seen before?  Do other people’s brains really do that automatically?  If so, that’s amazing!

3:20  There’s no “Aha!” moment for me when the faces go from upside-down to rightside-up.  It’s just the same image flipped.  Most people don’t have to turn their heads to read words that are printed upside-down, do they?  It’s the same for me with faces– if I don’t know them upside-down, I won’t know them rightside-up.  But flipping the image seems to cause instant recognition for Lesley Stahl.

4:00  Those poor people… I feel terrible for me too.  (Just kidding.)  : )

4:45  When you don’t automatically recognize faces, you use context to help you keep track of people.  If I understand what Dr. Novotny is describing, she can become familiar with a person as her current patient, but when they step outside into a crowd of people, their context is completely changed.  Now they are just one of many people visiting the hospital.  She might remember that the patient was a young woman with medium brown hair, but now there might be three other people in the room who fit that description, and if she makes an assumption, it could be wrong.

5:08  This is a nightmare scenario for me.  I would have to ask for the coworker’s e-mail address or try to text them, because even if he tells me his name, I will probably not recognize him in a different context.

Whenever I arrange to meet someone, I am usually not looking for a face I recognize.  I am looking for someone who fits the general description of the person I am meeting (age, gender, skin color, hair color, hair style, etc.) and who appears to be looking for me (by making eye contact or smiling when they see me).  Until I am sure who they are, I hedge by pretending to recognize them in a way that is hopefully also plausible as simple friendliness if they turn out to be someone I don’t know.

6:00  This exact thing happened to me with a friend who changed her hairstyle between school quarters.  She no longer had her hair in a ponytail, and that was enough to make me unsure that she was the same person until she greeted me by name!

I don’t experience quite as much dissonance as Jacob Hodes appears to, though.  If I saw a person change their hairstyle in front of me, they wouldn’t “disappear.”  I know they’re the same person because they haven’t gone anywhere.

8:00  The interview with artist Chuck Close is probably my favorite part of the segment.  I think he does a good job of explaining the thought processes a faceblind person uses to identify people, and showing how you can still be good at recognizing people by paying attention to details.  I think I also recognized the picture of Leno by the chin and of Tiger Woods by the lips.  I thought Tom Cruise was Doug Flutie, though.

Until I read about face blindness, I thought this was how everyone recognized faces.

10:00  I can echo what these people are saying.  The idea that most people have a mechanism that instantly and automatically “labels” faces for them seems as weird and unexpected to me as face blindness appears to be to Lesley Stahl.  Half the people I know say they are bad with faces, so I just figured I fit into the same category.  Maybe I do, and it’s a spectrum like autism rather than a sharp divide between “normal” and “not normal” the way the segment makes it appear.

11:05  Thanks, Ms. Stahl.  What a cheery thought!  (sarcasm)

12:00  I haven’t had the experience of not recognizing my own face, but I don’t really need to recognize it very often.  I mean, when I look in a mirror, the person in the mirror is going to be me, right?  Other people stay on my side of the mirror.

Moe by Michael Firman (click to visit webcomic)

Luna Lovegood and five positive Asperger’s traits

A lot of what you read about autistic and Asperger’s personalities tends to focus on their typical weaknesses, like social awkwardness and difficulty connecting with other people.  There’s a lot written about how traits like introversion can be a hurdle for autistics trying to fit in to a workplace or to form relationships.

But it’s a huge mistake to dwell only on the negatives.  Let’s ask a different question:  What are the strengths of an Aspie personality?  Can a person with Asperger’s or autism be a good coworker, a good friend?

I believe that the answer is yes, without a doubt!  People with autism, Aspies, shy people– have a lot to offer, especially if others are willing to listen and be patient with them.

I think that the character of Luna Lovegood in the Harry Potter series is a great example of some of the strengths of an Aspie personality, and the way her friends accept her is a great example of how to treat others who may seem a bit different.

Speaking as an Aspie, it tends to be hard for us to talk about our strengths because we are so constantly aware of our weaknesses, but I think it’s a little easier to point out the strengths of a fictional character like Luna.

With that in mind, here are five positive character traits I see in Luna that I think she shares with a lot of Aspies:

1. The fruit of time spent alone in thought.

Aspies tend to need a lot of time alone to sort out our thoughts.  It’s not that we are smarter or deeper thinkers than anyone else, but we are more easily distracted by all of the sensory data bombarding us from every angle and the conscious effort it takes to participate in the give-and-take of interacting with other people.

In some ways, the magical world of Hogwarts seems like it could be a nightmare for someone who is prone to sensory overload.  It has all of the noise and busyness of a school, with people headed every direction all the time.  But I think the most annoying thing would be the pictures.

All of the paintings on the walls at Hogwarts are enchanted, so the people and things in them can move and talk.  So you can be walking down the hall by yourself, and one of the pictures might try to start a conversation with you.  If have a light on late at night, they’ll all start complaining that they’re trying to sleep.  Sure, sometimes it’s funny, but I think it would get annoying feeling like you’re always being watched.  (And then even if you get away from the pictures, you still have to deal with the ghosts!)

Luna grew up in this sort of magical world, so maybe it doesn’t bother her that much.  On the other hand, it’s not that different from having to contend with blaring advertisements in a crowded mall or airport in the real world.

But she does seem to appreciate time alone.  In Order of the Phoenix, Harry Potter finds her in the forest feeding thestrals, the silent winged creatures that are invisible to most people.  When Harry asks why no one else seems to see them, Luna explains that she and Harry can see the thestrals because they have seen death– Luna lost her mother at the age of nine in an accident, and Harry was orphaned when he was just a baby.  Just months ago, Harry also witnessed a friend and classmate being murdered by the killer of his parents, the dark lord Voldemort.

At this point in the story, Harry is feeling isolated from his friends and ignored by his mentors.  He knows that Voldemort is about to strike openly and try to seize power, but the authorities are in denial.  They refuse to even speak Voldemort’s name and have published stories in the “respectable” papers portraying Harry as a liar.  Some of the people that Harry thought were his friends are avoiding him, and he has started to avoid them.

Luna quietly observes that perhaps Voldemort wants Harry to feel isolated.  “If I were You-Know-Who,” she says, “I’d want you to feel cut off from everyone else. Because if it’s just you alone you’re not as much of a threat.“

This isn’t the sort of insight that occurs to someone without the benefit of a lot of time spent sorting out her thoughts.  Who would expect a shy little girl to have spent time considering the strategy of a ruthless enemy?  It’s an insight she has arrived at only after a great deal of thinking quietly by herself.  Luna, too, has felt isolated, because of the teasing of the other students and the fact that she has experienced a loss that most children her age can’t relate to.

It turns out to be the insight that Harry most needed at that point in his life.

Asperger’s and Luna Lovegood– part 1

My family recently finished watching through the Harry Potter movie series, and I thought I’d write a bit about my favorite character in the story, Luna Lovegood.  As far as I’m concerned, Luna steals every scene she’s in.

In case you’re not familiar with the series, Luna Lovegood is a wizarding student attending Hogwarts one year behind Harry Potter’s class.  She isn’t introduced until the fifth story in the series, Harry Potter and the Order of the Phoenix.  It’s not difficult to believe that we never saw her before year 5, though, because she mostly keeps to herself, and no one wants to talk to her because she seems very strange.

Luna’s mother died when she was nine, and her father, Xenophilius (literally “lover of strangers/strange things”), is the editor of a paper called the Daily Quibbler, which is the magical equivalent of those tabloids they used to have in supermarket checkouts with front-page stories about Bigfoot being kidnapped by flying saucers.

No one takes such things seriously, except apparently Luna, who is always talking about magical creatures that no one (not even wizards!) has ever heard of and making other observations that seem to come from nowhere.  She tends to speak in a soft monotone and stare with a distant, almost expressionless gaze.

Luna (Evanna Lynch) introduces Harry Potter (Daniel Radcliffe) to a thestral.

Does it surprise you when I say that a lot of Harry Potter fans with Asperger’s syndrome or autism can see a bit of themselves in Luna?  She is often mentioned in discussions online about fictional characters who may be “Aspies.”

Such discussions almost always become quite tricky.  Even moreso than with a real person, a fictional character is shaped by the reader’s own perspective– he or she originally exists in the author’s imagination, but then each reader’s imagination “fills in the blanks” in its own way when picturing a character.

J.K. Rowling did not explicitly write the character of Luna Lovegood as a person with Asperger’s.  But because she is a good writer, she created a character with a distinct personality that is also familiar in many ways.  It’s an interesting balance– Luna seems like someone you might meet in real life, in large part because she is entirely different from any specific person– just as every individual is unique.  (I told you it was tricky.)

The nature of Asperger’s syndrome itself makes the prospect of “diagnosing” a fictional character even more nebulous.  Asperger’s itself is just a label for a set of traits that are often observed together– actually, not unlike a story.  It defines a rather blurry category, but the traits themselves do not describe any person exactly.  Nor does every person with Asperger’s look, think, or behave the same.

All of this is meant to explain that I’m not trying to argue that Luna Lovegood has Asperger’s syndrome.  I think that people in a lot of different situations can identify with her.  What I’m more interested in is describing the aspects of Luna’s personality and behavior in the movies that I identify with as a person with Asperger’s (and perhaps also a fairly quiet/shy person).

Brothers

Jonas and I sitting on the back of a giant turtle. Jonas is two years old in this picture, and I'm almost four.

When I was 20 months old, my younger brother Jonas was born.  In a lot of ways, we’re similar.  People in my family tend to be quiet and introverted.  We both like to study things in great detail.

But in other ways, our personalities have always been different.  After my tumultuous first few months, Jonas seemed like the happiest baby ever; he was a lot calmer than I had been.

This continued to hold true as we both grew.  One day when I was three or four, Jonas and I were in a room with a door that had a mirror fastened to it (not very securely, as it turned out).  Jonas grabbed the mirror, and it fell off the door, shattering with a loud crash!  Mom came running to find Jonas standing nonchalantly by the door with a cut on his finger from the mirror, and me crying and shouting hysterically.

“How many times have I told you not to do that?” I yelled at my brother again and again.  The answer to that question was zero– I had never mentioned it before– but it was something I had heard people say when they were angry, and I was mad at Jonas for making such a loud noise and a big mess!  It took longer to console me than it did to bandage Jonas’s hand.

Most of the time, though, I think Jonas and I got along very well.  It was a lot more fun playing and learning when I had someone to share the experiences with.

Jonas grew faster than I did– it was very common for people to ask my parents if we were twins.  I heard “No, they’re 20 months apart” so many times that I still often think of the age difference between us in months rather than years.

As we grew, Jonas tended to be more adventuresome and willing to try new things than I was.  He was usually the first to try an unfamiliar kind of food or a new activity.  In some ways, I suppose, he has been like a big brother to me, though he has never looked down on me as if I were a little brother.  Looking back now, I think there are a lot of experiences I wouldn’t have gotten the chance to enjoy if Jonas hadn’t been there to get me to try them.

Mother’s Day

Four days old.

I was born in Pittsburgh in May 1980, when the Steelers and Pirates were both defending champions.  My parents were younger then than I am now.  I asked my Dad once if he was nervous about becoming a parent for the first time, and he said, “Not really.”

You see, my father was a pediatrician, and my mother was a nurse, both of them very smart, caring people who had taken care of many children.  They always knew what to do when my brothers and I would get hurt or sick.

My mother has told me that I cried a lot.  All babies cry a lot, of course– what else is there to do?, but I cried a lot even for a baby.  Apparently, I was often uncomfortable.  My skin was easily irritated.  In general, I was overly sensitive– a description that would fit me all my life.

My mom would hold me for hours, trying to get me to stop crying.  At times, she was in tears, wondering how, with all of her training and experience as a nurse, she could seemingly calm any baby but this one.

I have no idea if my restlessness as an infant had any connection to Asperger’s (a term that hadn’t even been coined yet).  I did find it interesting to read of a similar experience in Daniel Tammet’s autobiography, Born on a Blue Day.  Tammet is autistic and experiences vivid synesthesia (perceiving things like words, numbers, and days as having colors and shapes).

When he was a baby, Daniel cried at all hours of the day, and his parents would calm him by making a sort of hammock out of a blanket and swinging it back and forth, each of them holding one end.  It does make sense to me that a baby with autism might experience the world with more sensitivity and take a longer time to adjust to that than a non-autistic baby, but I don’t have any real evidence to back that up.  I would imagine that experiences vary quite a bit depending on the individual.

But whatever the case, I am so thankful for my mother’s patient love.  Before I was even aware, I was loved unconditionally by my parents.  I think that my parents have been the most powerful testimony in my life about the love of God.  It’s because of that reflection that I have a concept of what God’s love is in a world that usually doesn’t reflect it clearly.  It’s why I can have hope even in the most painful or distressing times that all along, I have been resting in the arms of my heavenly Father.

Eye contact

Why do so many of us on the autistic spectrum have trouble making eye contact?  Lack of eye contact seems to be one of the traits most often named as going along with autism and Asperger’s syndrome.  Maybe that’s because eye contact is such an automatic thing for most people, they notice when it’s missing or brief, even in a young child.

Think of how often people attach significance to eye contact or its absence:  “I could see it in his eyes.”  “She couldn’t even look me in the eye when she told me.”  “He looked nervous; his eyes were constantly darting back and forth.”  These sorts of conclusions aren’t always right, particularly with an autistic person, because it’s very possible to be sending out a signal you don’t mean to without realizing it.  Someone might think I am looking down because I’m embarrassed by what I’m trying to say, when I’m actually just trying to concentrate on what I’m saying.

This is just a guess, but I don’t think that things like eye contact or body language are innate, because it is possible to learn them and improve throughout your life; it’s just that learning to make “normal” eye contact usually seems to take a lot more work for autistics than for others, and it often needs to be a conscious effort rather than something that we absorb automatically.

But what is it about the way our brains are wired that causes such a difference?  One theory comes from observations of brain activity in both autistic and non-autistic people as they performed a task involving face recognition.  Each hemisphere of the brain has a bundle of neurons deep inside it called the amygdala, and several studies have indicated that these parts of the brain behave differently in autistics than they do in non-autistics.

Here’s where it gets confusing.  I was all set to explain how experiments showed activity in the amygdalae for non-autistic people when they looked at human face to identify it or tried to read its emotions, while autistics showed little or no activity in the amygdalae.  That’s what a study in 2000 found.

But then I found a 2009 paper that reported the exact opposite!  This study concluded that there was actually more activity in the amygdalae of an autistic brain than there tended to be in a non-autistic brain.  When it comes to how the brain works, there’s a whole lot we don’t understand.

But anyway, the theory I’d heard before was that, for whatever reason, the part of the brain that most people use to process human faces as a special category of information doesn’t operate the same way in an autistic person.  Because of this, faces are processed the same way anything else is– a collection of visual information without any special “markers.”

So maybe autistics don’t tend to make eye contact because our brains don’t “latch on” to human faces as different or more significant than their surroundings in the way that neurotypical brains do.

When I heard this explanation, I thought it was interesting, but something about it didn’t seem quite right.  It wasn’t until I saw an ABC news segment about a remarkable girl named Carly Fleischmann that I was able to put it into words.

Changes

Hello again!  I decided to try out a different blog theme for this page.  All of the content is the same still.  What do you think?  I like the colors in this one, but the old one had a less complex background and may have been easier to read.

In general, people usually don’t like changes that aren’t necessary, but sometimes people on the autistic spectrum can be bothered by changes that others barely notice.  A couple of months ago, I read a blog entry posted by a mother whose little girl is on the autistic spectrum.  It was about a time she found her daughter struggling to hold back tears, telling herself “Sometimes things change, and that’s okay” in a method she had practiced to calm herself down.  The cause for her distress was that the TV show she was watching had changed its opening sequence for a new season.  She had been expecting the familiar opening that had been there every time, and something different was suddenly in its place.

I found that post very moving, because I can remember going through some of the same things as a young child.  One time, I was watching an episode of Sesame Street that somehow involved a marching band visiting the show.  I can barely remember the episode itself, but I do remember that as the credits rolled, they had the marching band perform the theme instead of using the piano and harmonica recording that had appeared every other time.  I was caught totally unprepared and burst into tears!  On a half-conscious level, I was familiar with each note and time interval in the song, and not only was the band using totally different instruments to play it, but they weren’t hitting all of the notes exactly right!  I just wanted to get away from it.

I had a similar reaction if I was listening to a song and the record or tape speed got messed up and the sound got distorted.  I always found it very disturbing to hear something familiar distorted into a grotesque form, with the essence of the original still there, just… twisted.

I am thankful that, as I have grown up, I have become less sensitive to that sort of sensory input.  I’m not entirely sure what has helped me besides experience, but I suspect that my love of science fiction may have helped me in this area.  Science fiction often uses a distorted or unfamiliar point of view to show readers or viewers something about human nature.  It can use a creature from another world as a mirror for ourselves, or it can show the consequences of our ideas by removing all limitations and showing what kind of future might result.  I’ve come to appreciate how storytellers use the weird and unsettling at times to tell a story of great importance and beauty.

Like anyone, I still worry about unwelcome changes in my life, of course.  But I still have the same thing to cling to as I did when I was a child– God never changes, and he has promised me that I belong to him.  Despite all the things in life that can scare or worry me, God is over them all, and he will not break his promises.

“I the LORD do not change. So you, the descendants of Jacob, are not destroyed.”

– Malachi 3:6

Hmm– I think I’ll keep this background for a while.  It seems to be helping me to start writing again.

Feeling disconnected

A few days ago, I got to see some of my classmates from Cedarville again for the first time in quite a while.  One of my friends was getting married, and it was a lovely wedding in which God was honored.

After the wedding, we went to the reception, which was held in the church’s gymnasium, and I found where my Cedarville friends were sitting and sat with them.

Have you ever been annoyed with yourself because you were in a time that should have been joyful and fun, but you were in a gloomy mood for no good reason?  I think that sort of happened to me.

As I think back on it now, there were a few things that were working against me.  To begin with, a wedding is the type of occasion that tests a lot of areas that I am weak in.  Making sure I am ready to go to the wedding requires using a lot of those executive functioning skills that are often tricky for Aspies.  I needed to make sure I had planned out what I was going to wear, what I needed to bring, and especially when I needed to leave in order to get there on time.  Driving increases my stress level a little more, and being in a social situation by myself bumps it up another level.

(What a whiny person I’m being!  I’m making it sound as if it’s such a hardship to do things that are a matter of simple courtesy.  This is part of the reason I’m annoyed with myself.  The fact is that it wasn’t that hard– I was glad that my friend invited me to her wedding, and I wanted to be there to share my best wishes for her and her husband.  I have a love/hate relationship with social situations in that part of me tries to avoid them, but I think deep down I really want to spend time with other people, and I almost always feel better after I have, even if it’s tiring sometimes.)

But the thing that seemed to mess up the meeting with my Cedarville classmates the most was unexpected– it was because I had a lot of trouble hearing what they were saying.  I mentioned that the reception was held in a gymnasium.  With so many people in a room with a basketball court for a floor, the echoing sounds of people’s voices in the background made it really hard for me to understand what my friends were saying.

It made me wonder if I’m losing my hearing.  I do like to listen to music a lot– is it possible the music is too loud?  Or is this more likely due to my brain processing sound input differently?  I have a difficult time tuning out background noise.

Whatever the case, I tried to have a conversation with each of my friends from Cedarville, but I wasn’t able to follow the larger conversation they were having as a group.  It got me thinking about how back when I was still going to Cedarville, I often felt the same way– not that I couldn’t hear what people were saying, but that I just didn’t know how to participate in the conversation on the same level as my friends.  It was sort of like being behind an invisible wall.  I wonder if it seemed to them like I was pushing other people away.

When I was talking to each of my classmates, I asked about how they were doing and what they were up to since graduating from Cedarville.  They are a bunch of really neat, talented people!  But it made me think about how little I knew about each of them even when I was still at Cedarville.

Anyway, sorry for making such a gloomy post.  I suppose that the positive side of this story is that it means I am getting a little better at interacting with others than I was ten years ago.  Otherwise, it wouldn’t have been such a shock to think back to how I was then.

Stage fright?

One of the blessings of being diagnosed with Asperger’s is that it has caused me to read the reflections of others who are on the autistic spectrum online.  Sometimes a person will describe how they feel in words that make me look at my own life from a different perspective.

That was the case in a message board discussion I read a while ago about social anxiety.  Someone had asked what it felt like, and one poster responded that they could be walking on a sidewalk past people just going about their days, and it would feel like trying to walk across a stage with a huge audience watching their every move.

I suddenly realized that I felt that way nearly every day whenever I walked from building to building on a college campus.  If there was anyone around at all, I would need to concentrate on where I was going to step, where I was looking, the look on my face, whether to say anything as I passed them– that’s what made just walking around outside so draining.  I was so used to feeling like that, that it had never occurred to me to use those words to describe it, though.

It occurs to me that I have never really struggled much with “stage fright.”  I was in a lot of church and school plays when I was a kid, and I even sang a solo in one of them.  I don’t think the crowd made me nervous when it came time for the first performance, because I had practiced plenty of times, and I had a script to follow.  When the play was over, though, I found a dark, empty room and hid in it– it took my family a while to find me.  At the time, I didn’t even know why I did it– it just felt right– but I think it was because I didn’t want to face all of the people who were going to talk to me and tell me I did a good job.  That was not something I had a script for.

I’ve also heard that for a lot of people, one of their greatest fears is having to speak in front of a crowd, with some ranking it ahead of death on their list of fears.  Giving a speech in one of my classes can be stressful for me, but only because I am worried about the task of organizing and delivering the speech itself.  It’s similar to having to write an essay; it has nothing to do with the fact that an audience is watching.  I’m not a particularly good public speaker, because I don’t usually pay any attention to the audience; I just deliver my “lines.”

Could it be that I have not struggled much with stage fright because I feel like I am always on stage?  If I’m in a group of people and we are asked to introduce ourselves one by one as an icebreaker, I have trouble concentrating on what anyone before me says because I’m trying to improvise my “lines” on the spot and make sure I remember them when it’s my turn to speak.  Sometimes I have to plan out my “stage directions” before I get up and start to do something, or else I’ll get confused and end up turning around a couple of times.

I find these kinds of observations interesting, but they are almost never universally true of all people on the autism spectrum.  Some Aspies have posted that they struggled greatly with paralyzing stage fright when they were in a play as a child.  I’m sure there are also plenty of people who have never had trouble with stage fright but are not on the autistic spectrum.

But overall, I found this an interesting line of thought.  What is the solution to this problem?  It might be easy to say that this shows I put too much weight on what other people are thinking.  I ought to be chiefly concerned with God’s view of me.  I’m sure that’s true, but I don’t think that entirely explains why I feel self-conscious at times.  I may perceive the presence of other people in a different way than others do.  Perhaps I just need more practice, or more improvisational skills, and one day I’ll forget I’m acting?

Changing the labels: The DSM-V’s proposed revision

Okay, so a couple of posts ago, I tried to give an overview of how the 4th edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (or the DSM) described the various diagnoses that fell under the category of the autistic spectrum.  The DSM provides guidelines for psychiatrists, pediatricians, and other medical professionals to use in diagnosing mental conditions.

Thankfully, it shouldn’t take me as long to tell about the way the 5th edition, planned for publication in 2013, defines the traits of autism.  Where before there were five different categories of “autistic spectrum disorders,” in the DSM-V, there will just be one:

Autism spectrum disorder

Must meet criteria 1, 2, and 3:

1. Clinically significant, persistent deficits in social communication and interactions, as manifest by all of the following:

a. Marked deficits in nonverbal and verbal communication used for social interaction.

b. Lack of social reciprocity.

c. Failure to develop and maintain peer relationships appropriate to developmental level.

2. Restricted, repetitive patterns of behavior, interests, and activities, as manifested by TWO of the following:

a. Stereotyped motor or verbal behaviors, or unusual sensory behaviors.

b. Excessive adherence to routines and ritualized patterns of behavior.

c. Restricted, fixated interests.

3. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities).

(from www.dsm5.org)

It kind of looks like the criteria for autism, Asperger’s, Childhood Disintegrative Disorder, and PDD-NOS have all been rolled together into one more inclusive category.  The APA’s website has some interesting comments about why they have decided to make this change:

“…distinctions among [autism spectrum] disorders have been found to be inconsistent over time, variable across sites and often associated with severity, language level or intelligence rather than features of the disorder.”

Originally, autism and Asperger’s were discovered and described separately.  It seemed for a while that Asperger’s could be considered a “mild” or “high-functioning” version of autism, but the more we have learned about them both, the more difficult it has become to draw a clear line between the two.

The APA says that “previously, the criteria were equivalent to trying to ‘cleave meatloaf at the joints.’”  The new criteria reflect this.